Understanding OCD

By Brian Robinson.

Almost always OCD has two main characteristics i.e. compulsions and intrusive thoughts. Compulsions are what they say on the tin: you have to do them. Intrusive thoughts are difficult too, not only because they are troublesome and uncompromising, but because the sufferer may believe the thoughts represent the absolute truth. The absolute truth is very difficult to escape from.

OCD, like all anxiety disorders, is inextricably linked with stress and high levels of tension. If the stress levels of the sufferer – physical, emotional and psychological – had been normal in the first place, then the chances are the disorder would not have emerged. This may not be true in every case, but this is usually how things work.

High stress levels energise an area in the brain which has a single imperative i.e. to keep us safe. This system can be split into three sections: anxiety and panic; phobias; and OCD. General anxiety and panic exists to spur the sufferer into action and to facilitate escape from danger. Phobias exist primarily to avoid danger. The sufferer is urged not to do this or that; not to be left alone; not to get into tight spaces etc. OCD exists purely as an action based safety measure. The sufferer is urged to act out compulsions in order to prevent bad things from happening. This can lead to a variety of rituals many of which make at least some logical sense. The thing to note here, is that the three elements mentioned above dovetail very neatly together with the common aim of keeping us safe.

A troubled mind no rest can find.

OCD is much better understood now and there are several approaches which can help sufferers. Medication, Exposure and Response Prevention Therapy (ERPT), and Mindfulness based CBT are probably the best known. However, what follows is a theoretical suggestion as to what might help with Response Prevention Therapy. It is something you might like to try to see if it helps. However, it should not be seen as a tried and tested coping or recovery model.

A key element to understanding OCD is the idea that it is an action based safety measure. And the OCD mind only relaxes when the sufferer is performing his or her rituals. Something which supports this idea is that frequently OCD sufferers report that relaxation exercises seem to make matters worse. The OCD mind simply does not want sufferers to be relaxing.

Here then is the suggestion: for example, when someone with contamination OCD is trying to delay washing themselves or washing items of clothing, instead of just sitting down, they should involve themselves in some other action. Ideally, the action should be something they want to do and not something they feel forced into doing. The idea being, that this alternative action may help to relax the OCD mind. We are trying to outwit the OCD mind rather than appease it.

Action can be a powerful distraction.

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